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NPI Code Detail

MEDICARE: IBRAHIM MALAK MD

MEDICARE:   IBRAHIM  MALAK  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician036091331MI

General Provider Information

NPI Number : 1982674115
Entity Type Code : Individual
Provider Name (Legal Business Name) : IBRAHIM MALAK MD
Provider Business Mailing Address
First Line : 800 S WASHINGTON AVE
Second Line : PATHOLOGY
City : SAGINAW
State : MI
Zip : 48601-2551
Country : US
Telephone Number : 989-907-8351
Fax Number :
Provider Business Practice Location Address
First Line : 800 S WASHINGTON AVE
Second Line : PATHOLOGY
City : SAGINAW
State : MI
Zip : 48601-2551
Country : US
Telephone Number : 989-907-8351
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2006
Last Update Date : 06/06/2014

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